Stone v. Department of Labor & Industries
Stone v. Department of Labor & Industries
Opinion of the Court
¶1 — Under chapter 51.32 RCW, a workers’ compensation claimant is precluded from receiving both a pension and a permanent partial disability award if the pension is based on the combined effects of two or more related injuries.
¶3 In 2001, Stone filed another workers’ compensation claim with DLI after he suffered an injury to his lower back. DLI allowed the claim, and Stone received treatment for his lower back and mental health conditions. In 2008, Stone requested a permanent partial disability award for at least 45 percent impairment to his knee. DLI never made such an award.
¶4 In April 2009, DLI issued two orders finding Stone to be permanently and totally disabled as a result of the combined effects of both the knee injury and the back injury in addition to his mental health conditions. Due to a typographical error, DLI then issued corrected orders for both claims in June 2009. DLI placed Stone on a pension, effective May 2009.
¶5 Stone appealed these orders. An industrial appeals judge issued a proposed decision and order after hearing testimony from Stone, two doctors, and a pension adjudicator. In July 2010, the Board of Industrial Insurance Appeals (BIIA) issued its decision and order, affirming both DLI orders. On appeal, the superior court affirmed the BIIA’s decision and order, adopting the BIIA’s factual findings as its own.
¶6 Stone appeals.
PERMANENT PARTIAL DISABILITY AWARD
¶7 Stone argues that DLI should have awarded him permanent partial disability benefits for his knee injury regardless of whether this prior injury was considered as
¶8 Judicial review in this court is governed by RCW 51.52.140, which provides that an “[a]ppeal shall lie from the judgment of the superior court as in other civil cases.” This statutory scheme results in a different role for this court than is typical for appeals from administrative decisions.
¶9 In carrying out this review, we take the record in the light most favorable to the party who prevailed in superior court and do not reweigh or rebalance the competing testimony and inferences, or apply anew the burden of persuasion.
¶10 A failure to assign error to the trial court’s findings of fact makes them verities on appeal.
¶12 The superior court adopted the BIIA’s 10 factual findings as its own.
1. Claim No. P-559303 [knee injury]:... On May 22, 2009, the claimant filed an appeal with the Board of Industrial Insurance Appeals of the April 1, 2009 order. On June 2, 2009, the Department corrected and superseded the April 1, 2009 order, terminated time-loss compensation benefits as paid through August 20, 2007, found the claimant totally and permanently disabled as a result of the conditions covered under Claim Nos. X-097249 and P-559303, and placed the claimant on a pension effective May 16, 2009, with the pension to be administered under Claim No. X-097249, and with no medical treatment covered after the effective date of the pension.
2. Claim No. X-097249 [back injury and mental health conditions]: ... On May 22, 2009, the claimant filed an appeal of the April 1, 2009 order with the Board of Industrial Insurance Appeals and on June 2, 2009, the Department corrected and superseded the April 1, 2009 order, terminated time-loss compensation benefits as paid through May 15, 2009, found the claimant totally and permanently disabled as a result of the conditions covered under Claim Nos. X-097249 and P-559303, and placed the claimant on a pension effective May 16, 2009, with the pension to be administered under Claim No. X-097249.
9. As of May 16, 2009, Mr. Stone was permanently unable to engage in reasonably continuous gainful employment as a proximate result of the March 31, 1997 and April 6, 2001 industrial injuries.
10. There was no proof that Mr. Stone was permanently unable to engage in reasonably continuous gainful employment as a proximate result of the April 6, 2001 industrial injury alone,*262 without taking into consideration the effects of the March 1, 1997 industrial injury.[11]
¶13 These unchallenged findings show that Stone received a pension based on the combined effects of two separate industrial injuries. This fact is crucial to a proper application of the relevant statutes.
¶14 Under the IIA, an injured worker may receive two types of benefits for permanent disabilities: (1) permanent partial disability and (2) permanent total disability. A “permanent partial disability” (PPD) includes loss of some bodily function and “any other injury known in surgery to be permanent partial disability.”
¶15 A “permanent total disability” (PTD) means “loss of both legs, or arms, or one leg and one arm, total loss of eyesight, paralysis or other condition permanently incapacitating the worker from performing any work at any gainful occupation.”
¶16 These two types of benefits are “ ‘separate concepts.’ ”
¶17 Stone primarily argues that he is entitled to a PPD award for his first industrial injury, notwithstanding his pension award for his second injury. In doing so, he relies primarily on RCW 51.32.060(4). That statute provides:
Should any further accident result in the permanent total disability of an injured worker, he or she shall receive the pension to which he or she would be entitled, notwithstanding the payment of a lump sum for his or her prior injury.[20]
In this case of first impression, Stone’s reliance on this statute, without considering any other relevant authority, is misplaced.
¶18 In McIndoe v. Department of Labor & Industries, the supreme court interpreted the meaning of “prior injury” within this statutory framework of the IIA.
¶19 It is not clear from the court’s holding in McIndoe whether a worker can receive a PPD award for a “prior injury” that is related to the award of PTD pension. We could find no published case that addresses this issue of first impression.
¶21 We agree that RCW 51.32.060(4) must be considered with former RCW 51.32.080(4) (2007).
If permanent partial disability compensation is followed by permanent total disability compensation, any portion of the permanent partial disability compensation which exceeds the amount that would have been paid the injured worker if permanent total disability compensation had been paid in the first instance shall be, at the choosing of the injured worker, either: (a) Deducted from the worker’s monthly pension benefits in an amount not to exceed twenty-five percent of the monthly amount due from the department or self-insurer or one-sixth of the total overpayment, whichever is less; or (b) deducted from the pension reserve of such injured worker and his or her monthly compensation payments shall be reduced accordingly.[24]
¶22 In McIndoe, the supreme court explained, albeit in dicta, how these two provisions affect one another.
¶23 The rationale behind former RCW 51.32.080(4) (2007) is found in Stuckey v. Department of Labor & Industries.
¶24 Here, Stone asks this court to overturn the superior court’s decision affirming DLI’s orders that found him “totally and permanently disabled as a result of the [combined] effects of the conditions covered under [the back injury and mental health claim] and [the knee injury claim].” He seeks an award of a PPD benefit for his prior knee injury in addition to his PTD pension. This request is contrary to the rationale that underlies former RCW 51.32.080(4) (2007) and the cases that have construed this statute. In essence, he seeks a greater benefit to which he is not entitled.
¶25 According to the plain language of former RCW 51.32.080(4) (2007) and the supreme court’s discussion in
¶26 The State also argues that the legislature’s 2011 amendment to RCW 51.32.080(4) supports this conclusion. It contends that the amendment clarifies that if a worker is permanently and totally disabled as a result of the combined effects of multiple claims, the worker is not eligible for a further PPD award for any of the claims that proximately caused the worker’s PTD. Because we have resolved this case on the basis of former RCW 51.32.080(4) (2007) and preamendment supreme court case authority, we need not address this argument.
¶27 Stone relies on Clauson v. Department of Labor & Industries to advance his argument.
¶28 There, the worker injured his right hip, and DLI gave him a PPD award equal to 35 percent of the amputation value of the right leg.
¶29 The court explained that Clauson was seeking a PPD award “for an injury which was sustained before the injury resulting in his permanent total disability and which was considered under a separate claim, which was pending at the time he was classified as permanently totally disabled .”
¶30 As DLI points out, implicit in this holding is the fact that Clauson’s first injury was unrelated to his second injury, and that his second injury was the basis for the award of a PTD pension. Clauson was entitled to a PPD award and a PTD pension because his two injuries were unrelated. This material fact distinguishes that case from this one.
¶31 In McIndoe, the supreme court made this factual distinction explicit.
¶32 Here, Stone suffered two separate injuries under two separate claims. But DLI’s determination that Stone should be placed on PTD pension rolls was based on the combined effects of both of his injuries, and thus the injuries were related. This finding is a verity on appeal in this case.
¶33 We note that our decision is consistent with significant decisions of the BIIA. The BIIA designates and publishes certain decisions as “significant decisions.”
¶34 In BIIA’s significant decisions In re Lusk
¶35 Here, the facts of Lusk and Maupin are similar to the present case. In these cases, the BIIA found that a worker could not receive a PPD award for an injury when the basis of a PTD pension is that same injury and another injury. The BIIA has been consistent in its decisions regarding this issue, and these decisions align with the Washington courts’ decisions.
¶36 Stone contends that In re Sulgrove,
¶37 In Sulgrove, a worker sustained an injury and was placed on a PTD pension for this injury.
¶38 Stone also argues that Sulgrove emphasized that a worker should not be penalized for administrative delay. He asserts that DLI should have closed his knee claim and awarded him a PPD award because he had reached “maximum medical improvement” as early as August 2007. But while administrative delay was a factor in Sulgrove, the decision was primarily based on the fact that the injuries were unrelated.
¶39 Next, Stone contends that DLI consolidated his right knee injury and lower back injury into “a single injury,” and “[n]owhere in the Act or appellate case law is the Department granted the authority to ‘reclassify’ conditions or disabilities into a single injury.” This argument is a mischaracterization of DLI’s orders. DLI decided that Stone was permanently and totally disabled as a result of both injuries. DLI did not conclude that Stone suffered only one injury.
¶40 Stone next argues that the “logical extrapolation” for the requirement that the injuries must be unrelated is that DLI could decide that most subsequent injuries are related
¶41 Finally, Stone argues that he is entitled to an award because of the liberal interpretation of the IIA. It is true that we resolve doubts in favor of the worker when construing the IIA.
¶42 In sum, we conclude that under chapter 51.32 RCW, Stone cannot receive a PPD award for his preexisting knee injury because his PTD pension was based on the combined effects of that same knee injury and a subsequent injury.
¶43 Stone requests attorney fees and costs on appeal under RCW 51.52.130 and RAP 18.1. RCW 51.52.130 provides, in pertinent part:
If, on appeal to the superior or appellate court from the decision and order of the board ... a party other than the worker or beneficiary is the appealing party and the worker’s or beneficiary’s right to relief is sustained, a reasonable fee for the services of the worker’s or beneficiary’s attorney shall be fixed by the court.
¶44 Here, Stone does not prevail in his appeal. Accordingly, he is not entitled to an award of fees.
¶45 We affirm the decision of the superior court affirming the decision of the BIIA.
Reconsideration denied February 8, 2013.
See former RCW 51.32.080(4) (2007); Stuckey v. Dep’t of Labor & Indus., 129 Wn.2d 289, 296, 916 P.2d 399 (1996).
Clerk’s Papers at 70-72.
Rogers v. Dep’t of Labor & Indus., 151 Wn. App. 174, 180, 210 P.3d 355 (2009).
Title 51 RCW.
Rogers, 151 Wn. App. at 180 (quoting Watson v. Dep’t of Labor & Indus., 133 Wn. App. 903, 909, 138 P.3d 177 (2006)).
Harrison Mem’l Hosp. v. Gagnon, 110 Wn. App. 475, 485, 40 P.3d 1221 (2002).
Ferencak v. Dep’t of Labor & Indus., 142 Wn. App. 713, 719-20, 175 P.3d 1109 (2008) (quoting R&G Probst v. Dep’t of Labor & Indus., 121 Wn. App. 288, 293, 88 P.3d 413 (2004)).
See Pellino v. Brink’s, Inc., 164 Wn. App. 668, 682, 267 P.3d 383 (2011).
Clauson v. Dep’t of Labor & Indus., 130 Wn.2d 580, 583, 925 P.2d 624 (1996).
Clerk’s Papers at 71.
11 Certified Appeal Board Record at 4-6.
RCW 51.08.150.
See RCW 51.32.080; Brief of Respondent at 1.
RCW 51.08.160.
See RCW 51.32.060.
McIndoe v. Dep’t of Labor & Indus., 144 Wn.2d 252, 262, 26 P.3d 903 (2001) (quoting Ellis v. Dep’t of Labor & Indus., 88 Wn.2d 844, 851, 567 P.2d 224 (1977)).
id.
20 (Emphasis added.)
144 Wn.2d 252, 263-64, 26 P.3d 903 (2001).
Id. at 266 (emphasis added).
This version of the statute was in effect at the time of the BIIA decision. The legislature subsequently amended this statute, effective July 1, 2011.
24 (Emphasis added.)
129 Wn.2d 289, 296, 916 P.2d 399 (1996).
130 Wn.2d 580, 925 P.2d 624 (1996).
Id. at 582.
Id.
Id.
Id.
Id. at 583.
Id.
Id. at 586.
Id.
See 144 Wn.2d at 266.
Id. at 266 (emphasis added).
See Pellino, 164 Wn. App. at 682.
See Clauson, 130 Wn.2d at 586; McIndoe, 144 Wn.2d at 266.
RCW 51.52.160.
Rogers, 151 Wn. App. at 183 n.10.
See Weyerhaeuser Co. v. Tri, 117 Wn.2d 128, 138, 814 P.2d 629 (1991).
Nos. 89 2984 and 89 3984, 1991 WA Wrk. Comp. LEXIS 60 (Wash. Bd. of Indus. Ins. Appeals June 14, 1991).
Nos. 04 14768, 04 15995, 04 18789, 04 18989, 04 20797, and 04 21093, 2005 WA Wrk. Comp. LEXIS 246 (Wash. Bd. of Indus. Ins. Appeals Dec. 6, 2005).
Maupin, 2005 WA Wrk. Comp. LEXIS 246, at *3; Lusk, 1991 WA Wrk. Comp. LEXIS 60.
Lusk, 1991 WA Wrk. Comp. LEXTS 60.
Maupin, 2005 WA Wrk. Comp. LEXIS 246, at *5.
No. 88 0869,1989 WA Wrk. Comp. LEXIS 22 (Wash. Bd. of Indus. Ins. Appeals May 1, 1989).
Lusk, 1991 WA Wrk. Comp. LEXIS 60.
1989 WA Wrk. Comp. LEXIS 22.
18 Wn. App. 674, 682-83, 571 P.2d 229 (1977).
7 Wn. App. 286, 295, 499 P.2d 255 (1972).
Brief of Appellant at 20.
Dennis v. Dep’t of Labor & Indus., 109 Wn.2d 467, 470, 745 P.2d 1295 (1987).
Elliott v. Dep’t of Labor & Indus., 151 Wn. App. 442, 450, 213 P.3d 44 (2009) (quoting Johnson v. Dep’t of Labor & Indus., 33 Wn.2d 399, 402, 205 P.2d 896 (1949)).
Reference
- Full Case Name
- Steven J. Stone v. The Department of Labor and Industries
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- Published